You’re 65 years old or older. You have to go to the hospital for a few days. Where will you go after you’re discharged?
Most of us would answer, “Home, of course.” But the fact is that 20 percent of seniors who are hospitalized end up being discharged to a nursing home. That’s what we discovered in this article from the age-related website NextAvenue. The point of the article seems to be that, while some seniors may need a short term stay for recovery and recuperation, a significant number wind up in nursing care long past the 100 days that Medicare considers a “short stay.” A handful of states in the U.S. have implemented plans to reduce the odds that seniors will end up in nursing care against their will. “If you are hospitalized at age 65 or older,” the NextAvenue article states, “there is a one in five chance you will be discharged to a nursing home. If you’re lucky, your stay in the nursing home will be relatively short — fewer than 100 days. Whether or not that happens, however, may depend on the state you live in.”
It’s actually in everyone’s best interests to reduce our society’s reliance on nursing homes, the article says, because skilled nursing care is far and away the most expensive form of long term care. NextAvenue quotes the 2017 Genworth Cost of Care report (we wrote about it in this recent AgingOptions Blog post) that prices the average semi-private nursing home room in the U.S. at over $85,000 annually. “The Genworth report also points out that two-thirds of Americans mistakenly think the government will cover most or all of this cost,” says NextAvenue. “On the contrary: Medicare pays for only a maximum of 100 days in a nursing home, and only after a hospital stay of at least three days. After those 100 days, patients get socked with the bill.” The sad result is that a significant number of seniors and their families will “burn through their savings and bankrupt themselves,” ending up on Medicaid (a program with severe financial troubles of its own). These skyrocketing costs, says the article, mean that “both families and the government have a huge incentive to keep people out of nursing homes in the first place.”
The NextAvenue article contains a link to a long and detailed report (you’ll find it here) co-authored by AARP, the Commonwealth Fund and the SCAN Foundation. The title – informative but not too exciting – is “State Strategies to Reduce the Risk of Long-Term Nursing Home Care after Hospitalization.” We didn’t read all 27 pages, but we did find a state-by-state comparison that shows how every state is doing in curtailing the number of new nursing home stays that end up becoming long-term – longer than 100 days. Washington State is in the top ten, just barely, with about 15 percent of new nursing home stays lasting more than 100 days. The best state is Arizona at about 9 percent, while the worst ones – those whose seniors have the highest odds of becoming unplanned long-term nursing home residents – are in the South: Texas (25 percent), Arkansas (27 percent) and the grand prize winner, Louisiana, where more than one-third of new nursing home admissions turn into long-term stays.
Several states are cited in the NextAvenue article for their innovative programs designed to help seniors stay out of long-term nursing home care. Oregon, for example, gives nursing home operators financial incentives to reduce excess nursing bed capacity and convert some of their efforts into assisted living, hospice care and home health care. In Minnesota, the state gives incentives to nursing home operators who successfully reduce their number of long-term residents, while also providing “community living specialists” who identify and assist seniors who are eager and able to return home. Connecticut offers financial assistance to home care services and makes it possible for those at varying income levels to receive in-home companion services, meals, minor home modifications and a host of other aging-related services, all on a sliding scale of costs. Meanwhile, Maine requires a medical assessment before a senior is admitted to a nursing home, and also gives residents and families a “community plan of care” detailing all the services they might be able to access as an alternative to moving into (or remaining in) a nursing facility.
The reasons to reduce reliance on nursing homes are much more than financial. “Beyond cost, most Americans want to age in their own home, or at least not in an institution,” says the NextAvenue article. As one author from AARP put it, “For the vast majority of them, [the goal] is to go back home or go back into the community. They want their privacy. They can eat when they want to eat. They can see who they want to see or not see them. That’s all about quality of life.”
At AgingOptions we applaud these efforts and initiatives, but we also fear too few families are taking this issue seriously. In the words of Rajiv Nagaich, this problem of seniors ending up in institutional care against their wishes “is going to be the new normal.” In Rajiv’s view, the challenges for those who fail to plan could get much worse. “Families will be increasingly burdened with caring for parents,” he says. “Medicaid benefits and availability will keep getting reduced. That’s why we emphasize proper education and solid support systems for seniors and their families.” The bottom line, says Rajiv: “It’s absolutely essential to think these things through before a health-related housing crisis happens.”
All this is a solid argument for an AgingOptions LifePlan. LifePlanning is our unique approach to retirement planning in which all the key threads of retirement are woven together into one unbreakable cord: your financial plan, your housing plan, your medical plan, your legal plan, and even your plan to communicate your wishes with your family. Without a LifePlan, any crisis can cause your dreams of a secure retirement to unravel quickly. But with a LifePlan in place, you’ll be able to protect your assets in retirement, avoid becoming a burden to those you love, and – as the NextAvenue article suggests – escape the trap of unplanned institutional care.
The next step is a simple one: join us for a LifePlanning Seminar with Rajiv Nagaich. In just a few information-filled hours, Rajiv will answer many of your retirement questions – even those you didn’t know you needed to ask – and will explain how a LifePlan can protect you as you age. There’s absolutely no cost and no obligation. Click here for all the details, then register online or call us during the week. It will be our pleasure to demonstrate for you the unmatched power of an AgingOptions LifePlan.
(originally reported at www.nextavenue.org)